Ayodeji I D, Schijven M, Jakimowicz J, Greve J W
Department of General Surgery, University Hospital, Maastricht, The Netherlands.
Surg Endosc. 2007 Sep;21(9):1641-9. doi: 10.1007/s00464-007-9219-7. Epub 2007 Mar 14.
The goal of our study was to determine expert and referent face validity of the LAP Mentor, the first procedural virtual reality (VR) laparoscopy trainer.
In The Netherlands 49 surgeons and surgical trainees were given a hands-on introduction to the Simbionix LAP Mentor training module. Subsequently, a standardized five-point Likert-scale questionnaire was administered. Respondents who had performed over 50 laparoscopic procedures were classified as "experts." The others constituted the "referent" group, representing nonexperts such as surgical trainees.
Of the experts, 90.5% (n = 21) judge themselves to be average or above-average laparoscopic surgeons, while 88.5% of referents (n = 28) feel themselves to be less-than-average laparoscopic surgeons (p = 0.000). There is agreement between both groups on all items concerning the simulator's performance and application. Respondents feel strongly about the necessity for training on basic skills before operating on patients and unanimously agree on the importance of procedural training. A large number (87.8%) of respondents expect the LAP Mentor to enhance a trainee's laparoscopic capability, 83.7% expect a shorter laparoscopic learning curve, and 67.3% even predict reduced complication rates in laparoscopic cholecystectomies among novice surgeons. The preferred stage for implementing the VR training module is during the surgeon's residency, and 59.2% of respondents feel the surgical curriculum is incomplete without VR training.
Both potential surgical trainees and trainers stress the need for VR training in the surgical curriculum. Both groups believe the LAP Mentor to be a realistic VR module, with a powerful potential for training and monitoring basic laparoscopic skills as well as full laparoscopic procedures. Simulator training is perceived to be both informative and entertaining, and enthusiasm among future trainers and trainees is to be expected. Further validation of the system is required to determine whether the performance results agree with these favorable expectations.
我们研究的目的是确定首款程序性虚拟现实（VR）腹腔镜训练器LAP Mentor的专家和参照者表面效度。
在荷兰，49名外科医生和外科实习医生接受了Simbionix LAP Mentor训练模块的实践入门指导。随后，发放了一份标准化的五点李克特量表问卷。实施过50例以上腹腔镜手术的受访者被归类为“专家”。其他人构成“参照”组，代表外科实习医生等非专家。
在专家中，90.5%（n = 21）认为自己是平均水平或高于平均水平的腹腔镜外科医生，而88.5%的参照者（n = 28）认为自己是低于平均水平的腹腔镜外科医生（p = 0.000）。两组在所有关于模拟器性能和应用的项目上意见一致。受访者强烈认为在对患者进行手术前有必要进行基本技能培训，并一致认同程序性训练的重要性。大量（87.8%）受访者预计LAP Mentor能提高实习医生的腹腔镜能力，83.7%预计腹腔镜学习曲线会缩短，67.3%甚至预测新手外科医生的腹腔镜胆囊切除术中并发症发生率会降低。实施VR训练模块的首选阶段是在外科医生住院实习期间，59.2%的受访者认为没有VR训练外科课程是不完整的。
潜在的外科实习医生和培训者都强调外科课程中VR训练的必要性。两组都认为LAP Mentor是一个逼真的VR模块，在训练和监测基本腹腔镜技能以及完整的腹腔镜手术方面具有强大潜力。模拟器训练被认为既信息丰富又有趣，预计未来的培训者和实习医生会充满热情。需要对该系统进行进一步验证，以确定性能结果是否符合这些良好期望。
